The Program in Health Services and Policy Analysis at the University of California, Berkeley, the Institute for Health Policy Studies, School of Medicine, University of California, San Francisco and the Institute for Health and Aging, School of Nursing, University of California, San Francisco (collectively, UCB/UCSF) propose to continue the UCB/UCSF Health Services Research Training Program for an additional five years. This broad-based, interdisciplinary program uses the resources of both UCB and UCSF to train health services researchers at both the pre and the postdoctoral levels. The Training Program is part of major health services research training efforts directed by Richard M. Scheffler, Ph.D. and Harold S. Luft, Ph.D., at UCB and UCSF. The UCB/UCSF Training Program provides one of the richest health services research educational environments in the U.S. The long term objectives of the Training Program are to train the nation's most qualified health services researchers in order that they may make significant contributions to our knowledge of health services issues and toward resolving current health policy crises. Dr. Scheffler will serve as the Principal Investigator of the Training Program and Dr. Luft will be co-director. Dr. Luft may serve as Principal Investigator in the fourth and fifth years of the Training Program. The need continues for quality research that can serve as the basis for informed decisions about health policy. The continuing difficulties with health care payment and access generate an ongoing demand for highly trained health services educators and researchers. Health services research also provides rewarding career opportunities for under- represented minorities. The proposed Training Program will give trainees an in-depth understanding of the U.S. health care system and the ability to deal with the system from social, political and economic perspectives. The training will occur through a combination of courses, seminars, mentored hands-on research and one on one career advising. Trainees will participate in a program that is tailored to their needs. All trainees will receive rigorous methodological and quantitative preparation that will enable them to conduct important interdisciplinary health services research and to make contributions toward understanding the policy implications of the issues they address. Training Program graduates will teach and conduct research in major U.S. universities and will become research leaders in government agencies and private sector research organizations. Most pre-doctoral trainees will enroll in Ph.D. programs at UCB or at UCSF. Roughly half of the postdoctoral trainees will have clinical backgrounds. The remaining trainees will have doctoral degrees from other fields. Continuation of the existing program aims to increase participation by under-represented minorities in health services research. The Training Program intends to continue its role as an essential part of the critical mass of training and health services research activities at UCB and UCSF.